The rural-focussed Specialist Training Program is widely regarded as a flop… but are there any better options?
If rural Australians are going to get fairer access to healthcare, according to National Rural Health Commissioner Professor Jenny May, around 30% of non-GP specialist training must occur in rural settings.
The current funding mechanism for non-GP rural training, the Specialist Training Program (STP), only accounts for around 7% of non-GP specialist training places.
And even then, it’s unclear whether this funding ever translates into true rural training.
“Most of the STP funding has gone metropolitan, so it didn’t fix the problem,” Council of Presidents of Medical Colleges Associate Professor Kerin Fielding told delegates at the Rural Medicine Australia conference on Friday.
“And so there’s been a big review, and [Professor Jenny May] and I were very involved in that, and we’ve given some updates to the government of what could be done to improve the access for rural, regional and remote sites to start training in rural, and the colleges are ready to go.
“We’ve done a lot of work in flexible approaches to training in expanded settings for states’ projects.
“Millions of dollars were put into projects between all the colleges to look at how we can train in expanded settings, how we can train in rural, different models of training, different models of supervision, cross-specialty supervision, sharing supervision of rural generalist specialists between colleges … and that that work has been shelved.
“We presented to the government three options for STP reform, and that that work has been shelved.”
Professor Susan Wearne, a GP who was speaking at the conference in her capacity as senior medical advisor to the health workforce division of the Department of Health, Disability and Ageing, said the work had in fact been paused, not shelved.
Speaking to The Medical Republic after the session, immediate past ACRRM president Dr Rod Martin said his experience was that state governments were one of the bigger roadblocks.
“[The specialist colleges] sit in that room and they know that they’ve got a whole bunch of people who are highly capable that should be able to get on a training post, and the state governments either can’t or won’t fund those posts,” he said.
It’s easier and cheaper for a state government, he said, not to have a workforce which required study leave and exam leave.
“I probably started in the in the job almost blaming the other colleges for that, and I’ve gone and done a 180 on it,” Dr Martin said.
“I think the colleges are all very well motivated, because we’re the ones that have got the patients and the waiting lists and the incredible lack of access.”
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One conference delegate questioned whether mode could be done from the federal end to ensure that states played ball – say, by using the National Health Reform Agreement.
Professor Wearne noted that page 131, schedule G of the National Health Reform Agreement 2026-2031 (consolidated) calls on states, territories and the Commonwealth to commit to “developing a shared evidence base, including exchange of relevant data and the use of nationally consistent data sets that enhances workforce planning”.
One of the stated goals was “increased and better collaboration between governments, education and training providers, post-graduate councils, professional colleges and/or associations and other relevant bodies to inform the coordination, setting and distribution of prevocational and vocational training numbers and capacity building efforts”.
Conference MC Dr Norman Swan put it to Professor Wearne that this sounded more like a “plea” than a directive.
“That is written in the National Health Reform Agreement, and that is what we are aiming to be working on in the next … five years,” she replied.
“That’s written in, and that is work that we’re actively doing.”
Professor Fielding confirmed that the CPMC had recently been invited to co-chair a short-term committee looking at the workforce for advanced training in non-GP specialities with DoHDA as a direct result of schedule G.
RMA26, which is jointly hosted by the Australian College of Rural and Remote Medicine and the Rural Doctors Association of Australia, is being held at the Adelaide Convention Centre until 24 October.
